The role of the government of Botswana in increasing rural and urban access to food

A conference paper on the role played by the government of Botswana in enabling access to food for both its urban and rural populations.Botswana’s food and agricultural problems are fully recognized by the government and are considered in its national economic priority agenda. In the November 1985 National Food Strategy paper, the state identified the following three problem areas of the country’s agricultural economy: inadequate domestic food production, inadequate nutrition and access^, and large food import and aid dependence-due to the country’s geographic location, the potential political instability in Southern Africa, and its implication for national food security (Botswana, 1985a).The research supporting the preparation the proceedings papers was financed by the U.S. Agency for International Development, Bureau of Science and Technology; Bureau for Africa; and the Southern Africa Regional Programme

Factors Associated with Treatment Delay among Pulmonary Tuberculosis Patients in Public and Private Health Facilities in Addis Ababa, Ethiopia

Background. Early detection and diagnosis of tuberculosis (TB) and the timely commencement of antituberculosis (anti-TB) treatment are the parts of efficient tuberculosis prevention and control program. Delay in the commencement of anti-TB treatment worsens the prognosis and increases the risk of death and the chance of transmission in the community and among health care workers. Objective. To assess tuberculosis treatment delay and associated factors among pulmonary TB patients in Addis Ababa, Ethiopia. Methods. A cross-sectional study was conducted in 10 public and 10 private health facilities that provide TB treatment. The data were collected from 425 newly registered pulmonary TB patients using pretested structured questionnaire from April to June 2012. Data were entered in EPI info version 3.5.1 and analyzed using SPSS version 16.0. Findings. The median durations of a patient, health care system, and total treatment delays were 17, 9, and 35 days, respectively. Overall 179 (42.1%), 233 (54.8%), and 262 (61.6%) of patients experienced patient delay, health care system delay, and total treatment delay, respectively. Distance more than 2.5?km from TB treatment health facility [AOR = 1.6, 95% CI (1.1-2.5)] and the presence of TB-associated stigma [AOR = 2.1, 95% CI (1.3, 3.4)] indicate higher odds of patient delay, whereas, being unemployed, patients with the hemoptysis symptom complain indicated lower odds of health care system delay [AOR = 0.41, 95% CI (0.24, 0.70)] and [AOR = 0.61 (0.39, 0.94)], respectively. Conclusions. A significant proportion of clients experienced patient and health care system delay. Thus, there is a need for designing and implementing appropriate strategies to decrease the delays. Efforts to reduce delays should give focus on integrating prevention programs such as active case detection and expanding access to TB care

Midwives' and obstetricians' perspectives about pregnancy related weight management in Ethiopia: A qualitative study.

BackgroundMidwives and obstetricians are key maternity care providers; they are the most trusted source of information regarding nutrition and gestational weight gain. However, their views, practices and perceived barriers to managing pregnancy related weight gain have not been studied in Ethiopia. The aim of this study was to explore midwives' and obstetricians' observations and perspectives about gestational weight gain and postpartum weight management in Ethiopia.MethodsWe conducted face-to-face interviews with 11 midwives and 10 obstetricians, from January 2019 to March 2019. All interview data were transcribed verbatim. We analysed the data using thematic analysis with an inductive approach.ResultsWe identified three themes and associated subthemes. Midwives and obstetricians had limited knowledge of the optimal gestational weight gain. Almost all participants were unaware of the presence of the Institute of Medicine recommendations for optimal weight gain in pregnancy. According to the study participants, women in Ethiopia do not want to gain weight during pregnancy, but do want to gain weight after the birth. Counselling about gestational weight gain and postpartum weight management was not routinely provided for pregnant women. This is mostly because gestational weight gain counselling was not considered to be a priority by maternity care providers in Ethiopia.ConclusionsThe limited knowledge of and low attention to pregnancy related weight management by midwives and obstetricians in this setting needs appropriate intervention. Adapting a guideline for pregnancy weight management and integrating it into antenatal care is essential

Gestational weight gain and its effect on birth outcomes in sub-Saharan Africa: Systematic review and meta-analysis.

INTRODUCTION:An increased metabolic demand during pregnancy is fulfilled by gaining sufficient gestational weight. Women who gain inadequate-weight are at a high-risk of premature birth or having a baby with low-birth weight. However, women who gain excessive-weight are at a high-risk of having a baby with macrosomia. The aim of this review was to determine the distribution of gestational weight gain and its association with birth-outcomes in Sub-Saharan Africa. METHODS:For this systematic review and meta-analysis, we performed a literature search using PubMed, Medline, Embase, Scopus, and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases. We searched grey-literature from Google and Google Scholar, and region-specific journals from the African Journals Online (AJOL) database. We critically appraised the included studies using the Effective Public Health Practice Project Quality Assessment Tool for Quantitative Studies. Two independent reviewers evaluated the quality of the studies and extracted the data. We calculated pooled relative-risks (RR) with 95% confidence intervals. RESULTS:Of 1450 retrieved studies, 26 met the inclusion criteria. Sixteen studies classified gestational weight gain according to the United States Institute of Medicine recommendations. The percentage adequate amount of gestational weight ranged from 3% to 62%. The percentage of inadequate weight was >50% among nine studies. Among underweight women, the percentage of women who gained inadequate gestational weight ranged from 67% to 98%. Only two studies were included in the meta-analyses to evaluate the association of gestational weight gain with pre-eclampsia and macrosomia. No difference was observed among women who gained inadequate and adequate gestational weight regarding experiencing pre-eclampsia (RR, 0.71; 95% CI: 0.22, 2.28, P = 0.57). Excessive gestational weight gain was not significantly associated with macrosomia compared to adequate weight gain (RR, 0.68; 95% CI: 0.38, 1.22, P = 0.20). CONCLUSION:A substantial proportion of sub-Saharan African women gain inadequate gestational weight particularly high among underweight women. Future interventions would need to design effective pre-pregnancy weight management strategies

Influence of gestational weight gain on baby's birth weight in Addis Ababa, Central Ethiopia: a follow-up study.

BACKGROUND: Gestational weight gain (GWG) is an important indicator of fetal well-being during pregnancy. Inadequate or excessive GWG could have undesirable effects on birth weight. However, information regarding the influence of GWG on birth weight is lacking from the Ethiopian setting. OBJECTIVE: This study aimed to determine the influence of GWG and other maternal-related factors on birth weight in Addis Ababa, Ethiopia. DESIGN AND METHODS: A cohort of pregnant women who received the first antenatal care before or at 16 weeks of gestation in health centres in Addis Ababa were followed from 10 January 2019 to 25 September 2019. Data were collected using a structured questionnaire and medical record reviews. We conducted a multivariable linear regression analysis to determine the independent effect of gestational weight on birth weight. RESULTS: Of the 395 women enrolled in the study, the participants' pregnancy outcome was available for 329 (83.3%). The mean birth weight was 3130 (SD, 509) g. The proportion of low birth weight (<2500 g) was 7.5% (95% CI 4.8% to 11.0%). Babies born to underweight women were 150.9 g (95% CI 5.8 to 308.6 g, p=0.049) lighter than babies born to normal-weight women. Similarly, babies whose mothers gained inadequate weight were 248 g (95% CI 112.8 to 383.6 g, p<0.001) lighter than those who gained adequate weight. Moreover, babies whose mothers had a previous history of abortion or miscarriages or developed gestational hypertension in the current pregnancy were 147.2 g (95% CI 3.2 to 291.3 g, p=0.045) and 310.7 g (95% CI 62.7 to 552.8 g, p=0.012) lighter, respectively, compared with those whose mothers had not. CONCLUSIONS: Prepregnancy weight, GWG, having had a previous history of abortion or miscarriages, and developing gestational hypertension during a current pregnancy were independently associated with birth weight. Pregnancy-related weight management should be actively promoted through intensive counseling during routine antenatal care contacts

Patterns and predictors of gestational weight gain in Addis Ababa, Central Ethiopia: a prospective cohort study

Introduction Gaining excessive or inadequate gestational weight is associated with many adverse maternal and fetal outcomes. Inadequate gestational weight gain (GWG) increases the risk of fetal growth restriction, pre-term birth, and low birth weight. It is a public health concern in sub-Saharan Africa. The aim of this study was to assess the patterns and predictors of GWG in Addis Ababa, Ethiopia. Methods We conducted a prospective cohort study among pregnant women who attended antenatal care in health centres in Addis Ababa, from January to September 2019. Data were collected by a structured questionnaire and checklists and analysed using Stata version-14. Weight at or before 16 weeks gestation was used as a proxy for pre-pregnancy weight. Women’s height and baseline weight were measured by data collectors, and we obtained weight at the end of the 24th and 36th weeks of gestation from women’s medical records. GWG was categorized as inadequate, adequate and excessive based on the United States Institute of Medicine criteria. Predictors of GWG were identified using multinomial logistic regression. Results A total of 395 pregnant women were enrolled in the study. GWG was assessed for 369 (93%) women. The median GWG was 8.7 kg with inter quartile ranges (25th, 75th percentiles) of 7.0 kg and 11.6 kg. More than two-third of the participants, 248 (67.2% [95% CI: 62.2, 72.0%]), gained inadequate weight; 103 (27.9% [95% CI: 23.4, 32.8%]) gained adequate weight; and 18 (4.9% [95% CI: 2.9%, 7.6%]) gained excessive weight. Three quarters (75%) of underweight women gained inadequate gestational weight, whereas 43% of overweight or obese women gained inadequate gestational weight. Being underweight (AOR = 3.30 [95% CI: 1.32, 8.24]) or normal weight (AOR = 2.68 [95% CI: 1.37, 5.24]) before pregnancy increased the odds of gaining inadequate gestational weight compared to overweight or obese women. Not having paid employment was associated with higher odds of gaining inadequate gestational weight compared to women employed outside the home (AOR = 2.17 [95% CI: 1.16, 4.07]). Conclusions Most pregnant women in Addis Ababa gain inadequate gestational weight. In particular, three quarters of underweight women gained inadequate gestational weight. Being underweight, normal weight or having no paid employment were associated with higher odds of inadequate GWG. Promoting adequate GWG in Addis Ababa among underweight and normal weight women may be an important public health initiative

Population Based Survey of Chronic Non-Communicable Diseases at Gilgel Gibe Field Research Center, Southwest Ethiopia

BACKGROUND: Chronic Non-communicable Diseases are increasingly becoming more prevalent and burden to the health care system in developing countries including Ethiopia. However, evidences showing the magnitude of the problem in those countries are scarce particularly in a community setting.The objective of this study was to determine the magnitude of chronic non communicable diseases in a community.METHODS: A population-based cross-sectional study was conducted in Gilgel Gibe Field Research Center from late September 2008 to end of January 2009. A random sample of 4,469 individuals aged 15-64 years was studied. Data on characteristics and chronic symptom inventories were collected by interviewing study participants. Blood pressure was taken three times from each individual and blood sugar and lipid levels were determined after an overnight fasting. Data were analyzed using SPSS for Windows version 16.0 and STATA 11.RESULTS: The overall prevalence of CNCD was 8.9% (7.8% men and 9.8% women). The specific observed prevalence were 0.5% for diabetes mellitus (DM), 2.6% for hypertension, 3.0% for cardiovascular diseases, 1.5% for asthma and 2.7% for mental illness. In addition 3.1% and 9.3% of the study population had been informed to have DM and hypertension respectively.CONCLUSION: There is a high prevalence of CNCD among the study population indicating an immediate need for preventive action and also warrant further nationally representative study.Keywords: CNCD, Non-communicable, Prevalence, Southwest Ethiopi

Metal doped carbon nanoneedles and effect of carbon organization with activity for hydrogen evolution reaction (HER)

AbstractCellulose nanowhiskers (CNW) from cotton, was prepared by acid hydrolysis and purified using a size selection process to obtain homogeneous samples with average particle size of 270nm and 85.5% crystallinity. Purified CNW was used as precursor to carbon nanoneedles (CNN) synthesis. The synthesis of CNN loaded with different metals dopants were carried out by a nanoreactor method and the obtained CNNs applied as electrocatalysts for hydrogen evolution reaction (HER). In the carbon nanoneedles synthesis, Ni, Cu, or Fe worked as graphitization catalyst and the metal were found present as dopants in the final material. The used metal appeared to have direct influence on the degree of organization of the particles and also in the surface density of polar groups. It was evaluated the influence of the graphitic organization on the general properties and nickel was found as the more appropriate metal since it leads to a more organized material and also to a high activity toward HER

Identifying the structure of Zn-N-2 active sites and structural activation

Identification of active sites is one of the main obstacles to rational design of catalysts for diverse applications. Fundamental insight into the identification of the structure of active sites and structural contributions for catalytic performance are still lacking. Recently, X-ray absorption spectroscopy (XAS) and density functional theory (DFT) provide important tools to disclose the electronic, geometric and catalytic natures of active sites. Herein, we demonstrate the structural identification of Zn-N-2 active sites with both experimental/theoretical X-ray absorption near edge structure (XANES) and extended X-ray absorption fine structure (EXAFS) spectra. Further DFT calculations reveal that the oxygen species activation on Zn-N-2 active sites is significantly enhanced, which can accelerate the reduction of oxygen with high selectivity, according well with the experimental results. This work highlights the identification and investigation of Zn-N-2 active sites, providing a regular principle to obtain deep insight into the nature of catalysts for various catalytic applications